Objective: To rationally reduce the fees and improve the development of large public hospitals. Methods: Analyze the relationship among the fees, hospital economic activity and medical treatment price mechanism in large public hospitals based on resource dependence theory. Results: Price control can not effectively control the costs. Conclusion: Medical price mechanism reform should in the direction of medical system reform, avoid the “quantity success” in large public hospitals, strive for patients with basic medical health institutions; then it should adequately embodies the value of technical work value of medical project and stimulates the initiative of the doctor.

The present paper reviewed the recent researches on the toxicity and health effect of phthalate in the following four aspects: animal toxicology, population epidemiology, people exposure, and safety standard, moreover, some critical problems which should be studied as soon as possible were proposed.

ObjectiveTo introduce a rapid and stable rat model of middle cerebral artery occlusion (MCAO). Methods32 Wistar male rats were used to induce focal cerebral ischemia according to Longa's method. The main difference from Longa's was to introduce a nylon suture into the cervical internal carotid artery without ligation the pterygopalatine artery (PPA). Regional cerebral blood flow (rCBF), neurological deficit, brain water content, red tetrzolium (TTC) stain and pathology were evaluated in all rats.ResultsThe operation proceeded about 15 min after anaesthesia. Rats after operation presented severe neurological deficits companied with rCBF decreases. There were significant increases of brain water contents in ischemic brain regions. TTC staining showed infarct areas and histological examinations revealed remarkable astrocyte swelling and neuronal necrosis.ConclusionInducing rat MCAO without ligation of PPA could produce reliable ischemic changes,with the advantage of shortening operation time.

Objective To evaluate the significance of the treatment of intra- and extra- hepatic recurrent stones through the subcutaneous jejunal loop. Methods The authors respectively analyzed 24 cases of intra- or extra- hepatic recurrent stones and/or acute cholangitis treated through the subcutaneous jejunal loop from January 1989 to January 2003. Results Of the 24 cases, 10 cases (18 times) of acute cholangitis received drainage through the subcutaneous jejunal loop and their symptoms relieved (18/18); 14 cases (17 times) of recurrent intra- and extra- hepatic stones received selective drainage placement through the subcutaneous jejunal loop. The extra- or intra- hepatic stones were removed under choledochoscope through the subcutaneous jejunal loop, the stone clearance rate being 79.2% (19/24). Conclusions It is a convenient, minimally invasive, and effective method to treat intra- and extra- hepatic recurrent stones through the subcutaneous jejunal loop.

3)between theventral divison of the middle part and the other parts of the locus coeruleus.Theneurons of the locus coeruleus were mainly medium-sized(59.25%),the smaller andlarger ones were observed in 33.75% and 7% respectively.

To study the determination method of cholesterol in human serum by Coulometric titration. METHODS: The titration was carried out in an electrolytic solution containing 1 mol.L-1 potassium bromide and glacial acetic acid (1∶3). Bromine was electrogenerated at the anode and cholesterol reacted with bromine with a value of reactional electrons (n) as 2. RESULTS: The ranges of recovery for 0.115 mg to 0.459 mg of cholesterol were from 93.9% to 105%, and the average recovery was 100.3%. The relative standard deviation in all applied analysis was less than 1.5%. The accuracy of the method was also assessed in comparison with the results obtained by the enzymatic method used clinically. CONCLUSION: The method proposed is simple, rapid and accurate, and is suitable for the determination of cholesterol in human serum samples.

Objective To study the long-term effect of different surgical procedures for juxtapapillary duodenal diverticula accompanying biliopancreatic diseases. Methods The study included 86 cases of juxtapapillary duodenal diverticula accompanying biliopancreatic diseases treated with different operations from April 1982 to October 2001.The 5-year incidence of postoperative cholangitis was retrospectively analyzed using the life table method. Results There were 45 cases of treatment of biliopancreatic diseases without management of the diverticula,9 cases of Roux-en-Y choledochojejunostomy,11 cases of subtotal gastrectomy with gastrojejunostomy(Billroth Ⅱ),and 13 cases of sphincteroplasty,with their incidences of cholangitis in 5 years being 52.0%,40.0%,75.0%,and 66.7%,respectively. Other procedures were carried out in 8 cases.There was no statistically significant difference in incidences of cholangitis in 5 years among these procedures(?~2=1.49,P=0.8287). Conclusions Management of juxtapapillary duodenal diverticula is not required in patients without the stenosis of the papilla.If postoperative cholangitis cannot be explained with biliary diseases,surgical procedures should be performed depending on the patient's individual condition and the surgeon's experience.The incidences of cholangitis in 5 years among these procedures are not significantly different.

Objective To explore rational and effective treatment strategies by comparing long-term effects of different treatment methods for hepatolithiasis. Methods One hundred and fifty-nine cases of hepatolithiasis treated in this hospital from January 1993 to December 2002 were analyzed retrospectively.Five treatment methods: conservative treatment,choledocholithotomy followed by choledochostomy,hepatolobectomy,hepaticojejunostomy,and hepaticoplasty with the conservation of the Oddi's sphincter,were compared in respect of postoperative complications and long-term outcomes.Results Out of the 159 cases,follow-up was completed in 146 cases(91.8%,146/159) for 2~12 years(median,7 years).Of 16 cases of conservative treatment,15 were followed.Cholangitis occurred in all the 15 cases,with 1 fatal case.Of 47 cases of extrahepatic surgical exploration,the incidence of residual stones was 100%.Follow-up in 43 cases found 32 cases of cholangitis(74.4%) with 7 fatal cases.Of 16 cases of hepatolobectomy,residual stones were noted in 3 cases(12.5%).Follow-up in 15 cases found 4 cases of cholangitis(26.7%) with 1 fatal case.Of 32 cases of hepaticojejunostomy,residual stones were found in 11 cases(34.4%).Follow-up in 29 cases found 14 cases of cholangitis(48.3%) with 3 fatal cases.Of 48 cases of sphincter-sparing operation,residual stones were found in 8 cases(16.7%).Follow-up in 44 cases found 7 cases of cholangitis(15.9%).The incidence of residual stones was significantly higher in cases of extrahepatic surgical exploration than in cases of other treatment(P=0.000).The recurrence rate of cholangitis was significantly higher in cases of conservative treatment and extrahepatic surgical exploration than in cases of other treatment(P

1.5 cm in diameter) are significant risk factors for the failure of stone clearance. Prophylactic cholecystectomy of an acalculous gallbladder is unnecessary.